基于集聚度的广西卫生人力资源公平性分析

目的 对2010-2017年广西卫生人力资源公平性进行分析,为制订科学合理的卫生人力发展计划和政策提供参考;方法 横向上将广西14个地级市按经济发展水平由高到低分为3类城市,运用集聚度方法对不同经济发展水平城市卫生人力配置的公平性进行评价;纵向上对2010-2017年广西不同类别卫生人力资源的公平性进行集聚度分析;结果 从横向上看,无论是按地理配置还是按人口配置的卫生人力资源,Ⅰ类地区公平性＞Ⅱ类地区公平性＞Ⅲ类地区公平性;从纵向上看,2010-2017年广西各类卫生人力资源的集聚度呈上升势态,其中注册护士集聚度最高,执业(助理)医师集聚度最低;结论 广西不同经济发展水平地区间公平性分化严重,低人口密度地区按地理配置的卫生人力资源公平性较差,少数民族人口聚居地区卫生人力资源公平性欠佳,按人口配置的医师公平性较低。     

基于基尼系数和泰尔指数的云南省乡镇卫生院 卫生资源公平性分析

摘要:目的　分析云南省2007-2012年乡镇卫生院卫生资源配置的公平性状况,为区域卫生规划提供基础信息。方法　采用计算基尼系数和泰尔指数的方法分析这6年来云南省乡镇卫生院卫生资源配置的公平程度及其变化趋势。结果　2007-2012年,床位、卫技人员、执业（助理）医师、注册护士等4种卫生资源的基尼系数均小于0.3,且呈逐年下降趋势;泰尔指数与基尼系数有相同的趋势;同年度4种卫生资源中,床位的基尼系数最小且泰尔指数也最小;2011-2012年,区域内贡献率高于区域间贡献率。结论　云南省乡镇卫生院床位、卫技人员、执业（助理）医师、注册护士等卫生资源配置公平性较好,硬件配置公平性优于软件配置公平性,区域内差异是造成乡镇卫生院卫生资源配置不公平的主要原因。     

公平与效率相统一的资源节约型道路是中国“医改”的基本落脚点

在欠发达、有13亿人口的中国，“医改”必须在体制机制上摒弃“欠公平、高消耗、低效率”的模式；坚持公平性，追求总体效率最高、资源最节约，使人人享有相对比较公平的初级卫生保健服务，在全民族健康水平和享有的医疗卫生服务水平得到较快提高的同时，社会总资源的消耗始终保持在与国民经济发展水平相适应的、国家和人民承担得起的、相对比较低的水平。这是中国医疗卫生事业唯一的长治久安之路。     

A price to pay: The impact of user charges in ashanti-akim district,Ghana

In present constrained economic circumstances, many governments have introduced or increased user charges for health services. This has been advocated by the World Bank, justified by reference to the raising of revenue, efficiency and, controversially, even the promotion of equity. This paper examines the impact of user charges on utilisation in the Ashanti-Akim district of Ghana since the introduction of charges in 1985. In many ways, user charges have been a success: in recovering fees and maintaining urban utilisation. However some advantages have not materialised because the health infrastructure has not changed adequately. More importantly, equity and affordability have been problematical. For some of the population, services are no longer affordable.     

武汉市7家医院头孢菌素类抗生素的供应调查

目的:调查并分析武汉市7家医院头孢菌素类抗生素的供应情况。方法:对武汉市7家医院2004年3月~6月间供应头孢菌素类抗生素的品种、类型、价格差异进行数据处理。结果:武汉市7家医院供应的头孢菌素类抗生素以第3代为主,供应企业多,相同品种规格重复,药品同质性强,同品种价格差异大。结论:医院药品供应结构的合理化是促进临床合理用药的基础。     

Patient characteristics and fairness

This study examines the fairness concept of health care professionals, and asks whether they are willing to use a patient’s age and other potential fairness characteristics rather than health benefits as relevant arguments in the allocation of health care resources? The patient characteristics in the health care professionals’ survey encompass age, productivity and lifestyle. The study is a replication of a much older study from the 1970s. The present study finds that the understanding of fairness among health care professionals differs from concepts of fairness in legislation. The status of various patient characteristics as rationing arguments has remained much the same, although nowadays health care professionals are expected to be more aware of moral dimensions and also legislation on patients’ rights. The fairness concept of health care professionals may lead to resource allocation decisions that deviate from the intention of such legislation.     

Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda

Violent conflicts claim lives, disrupt livelihoods, and halt delivery of essential services, such as health care and education. Health systems are often devastated in conflicts as health professionals flee, infrastructure is destroyed, and the supply of drugs and supplies is halted. We propose that early reconstruction of a functioning, equitable health system in countries recovering from conflict is an investment with a range of benefits for post-conflict countries. Building on the growing literature about health systems as social and political institutions, we elaborate a logic model that outlines how health systems may contribute not only to improved health status but also potentially to broader statebuilding and enhanced prospects for peace. Specifically, we propose that careful design of the core elements of the health system by national governments and their development partners can promote reliable provision of essential health services while demonstrating a commitment to equity, strengthening government accountability to citizens, and building the capacity of government to manage core social programs. We review the conceptual basis and extant empirical evidence for these mechanisms, identify knowledge gaps, and suggest a research agenda.     

情境、问题和伦理学进路的变化：《应用伦理学百科全书》--从第1版到第2版

自1998年第一版《应用伦理学百科全书》出版以来,世界发生了变化。千禧年和“9·11”后的情境使得应对恐怖主义变为重点,例如对生物识别技术等技术手段的关注越来越多。然而不仅社会政治情境发生了改变,在科学领域,人类基因组测序、干细胞科学的展望以及合成生物学的兴起都引发了相当大的争论。伦理学问题也日益具有全球意义。第二版百科全书处理了1998年的版本中没有或只略微涉及的问题。然而,它仍然保留了那些被视为“经典”的文章,并在必要时进行更新,以反映对应用伦理学进路思考的进展。在这里,试图勾勒出这期间争论进展的主要趋势和途径。这些途径可分为三类,由于情境的变化,问题的变化和伦理学进路的变化所引起。     

北京市西城区社区卫生资源配置公平性研究

目的对北京市西城区社区医疗卫生资源配置公平性进行分析评价,为卫生行政部门优化资源配置提供决策依据。方法采用洛仑兹曲线(Lorenz curve)和基尼系数(Gini coefficient),从人口分布和地理分布的角度,分析西城区社会医疗资源配置的公平性。数据来源《第六次全国人口普查汇总数据》(2010年)、2009~2011年北京市西城区统计年鉴、2011年西城区卫生局卫生统计数据。结果社区医疗卫生机构、卫生技术人员按人口分布的基尼系数分别为0.16、0.15;社区医疗卫生机构、卫生技术人员按地理的基尼系数分别为0.18、0.2。结论西城区社区医疗卫生资源总量处于较低水平,卫生资源地理配置公平性低于人口配置公平性。